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Individual Rights vs the Public Health: The Problem of the Asian Hepatitis B Carriers in America

Author

Muraskin, William

Bibliographic Citation

Social Science and Medicine. 1993 Feb; 36(3): 203-216.

Abstract

The influx of Asians into the United States (both as refugees and
immigrants) presented American public health authorities with a significant
challenge because many of them were chronic hepatitis B carriers. The carriers
posed a real, but undetermined level of risk of spreading the infection to the
larger community. Of especial importance was the danger that susceptible
children would be infected in day-care centers, because the earlier the age of
exposure, the greater the risk of developing chronic carriership; which in
turn is associated with cirrhosis and cancer of the liver in later life. The
Asian carriers presented both a health problem, and a moral dilemma. If the
carrier situation became a subject of public debate, there was danger of a
racist and discriminatory reaction to the newcomers. Faced with this problem,
American public health authorities opted to protect the Asian carriers by
assuring the medical profession and concerned members of the public that there
was either no health risk, or the risk was easily controllable, despite the
lack of evidence to support such positions. In their attempt to protect a
vulnerable group from discrimination, they functioned as humanitarians, but
abrogated their duty as scientists and thereby undermined the long-term
credibility of those charged with protecting the public health. Thus, despite
achieving some immediate benefits for a defenceless group, the price they paid
for that protection was too high.